| NPI | 1508892555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2813) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me84838) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2009-07-17 |